Intramedullary rods or nails have been used to treat femoral, tibial, humeral and other bone fractures. Moreover, they have been used for fusions and repairs of unhealed or crooked bones. Femur, tibia, and humerus fractures, for example, have been treated with rod assemblies that for example are inserted into the canal to coapt the fractured parts. Peritrochanteric fractures of the femur, for example, have been treated with femoral rod assemblies that for example are inserted into the femoral canal to coapt the femur fractured parts. One or two angled cross-nails or locking screws are inserted through the bone at the proximal and distal ends of the intramedullary rod. Rods have been provided that permit the angle of the proximal screw relative to the rod to be adjusted in situ.
Implant insertion devices, such as targeting guides, have been provided for introducing intramedullary rods into bones, such as the femur, tibia, humerus, and between bones such as the calcaneus-talus-tibia or femur-tibia. Such devices can align a guide sleeve, with a locking screw inserted through the guide sleeve, relative to the bone so as to insert the screw into the nail and bone. Several implant insertion devices may be needed to accommodate for different angles between the screw, which is inserted through the nail, and the nail itself, because such devices typically provide only a single angle between the screw and the nail. Some implant insertion devices require disassembly of at least a portion of the device to remove a first insert with a first static angle for the guide sleeve and provide a second insert with a second static angle for the guide sleeve in order to change the angle at which the guide sleeve and locking screw are aligned relative to the nail. Some implant insertion devices require the guide sleeve to be removed, be uncoupled and rotated transversely into a constrained location in a stepwise manner in order to allow for, at most, a fixed five degree incremental step wise change from 120 degrees to 125 degrees to 130 degrees to 135 degrees without the ability to dynamically move throughout the range of angles in a smooth, continuous or non-incremental manner.
There is a need for an improved implant insertion device which permits the angle of the guide sleeve, and locking screw secured to the distal end of the guide sleeve, to be continuously adjusted on the device over a range of angles without removing the guide sleeve from the device or disassembling any portion of the device.